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Why an employee might need to submit a claim

Nonstop Health provides your employees with a Visa card to help them pay for covered eligible expenses. But there may be times when they don’t have their Nonstop Visa card with them. Not a problem! They can still use Nonstop Health!

They will just need to pay up front and be reimbursed via Nonstop’s claims process. Or, if they need to pay a copay or coinsurance, employees should ask their provider if they will bill them for the service. 

When is a claim submission not needed?

• If an employee uses their Nonstop Visa card to pay for an in-network and covered eligible expense. Employees only need to submit a claim if they paid out-of-pocket and need to be reimbursed, or if, for some reason, they couldn't use their Nonstop Visa card.
• If an employee swiped their Nonstop Visa card for a covered expense, and they don't receive an email that the charge needs further review (substantiation), that's good! The expense went through.

Let's talk about the claims process

How does the claims process work? What documentation does Nonstop need with each submission?

• There are four ways to submit a claim:
  
  • Online via the Nonstop Exchange (NSE) member portal (members.nonstophealth.com)
  • Email
  • US Postal Service
  • Fax
• What documentation does Nonstop need?
  
  • If the employee wants Nonstop to pay a medical provider directly on your behalf:
    
    • Explanation of Benefits (EOB) or Remittance Advice Report
    • All pages of the provider bill (showing the account number and where payment should be sent)
    • Completed Nonstop claim form
  • If the employee wants to be reimbursed for payment(s) you made to a medical provider or for a medical service:
    
    • EOB or Remittance Advice Report
    • Proof of payment
    • Completed Nonstop claim form
  • If the employee wants to be reimbursed for payment for a prescription:
    
    • Detailed pharmacy bag receipt or pharmacy printout (showing your name, the medication name, and whether it was processed through/covered by their health insurance carrier)
    • Proof of payment (e.g. cash register receipt)
    • Completed Nonstop claim form